Using a longitudinal, large-scale sample of British twins, we addressed the prediction of both cognitive abilities and behavioral adjustment from eight domains of environmental risk: minority status, socio-economic status, maternal medical factors, twin medical factors, maternal depression, chaos within the home environment, and parental feelings towards their children and discipline. Participants included 5765 families with twins (49.1% male) born in 1994 and 1995. Aspects of environmental risk were assessed from birth until the children’s third birthdays; outcome measures were assessed at their fourth birthdays. Overall prediction of outcome (via multiple regression analysis) was moderate (R = .23 – .48). SES and chaos were the strongest predictors for the cognitive outcomes whereas for total behavior problems the more proximal parenting factors were also dominant. Future analyses will investigate these environmental risk indicators in the context of the genetically sensitive twin design.
Keywords: [none]
OBJECTIVE: The aim of this study was to investigate the associations between children’s difficulties (conduct problems, hyperactivity/impulsivity, and emotional symptoms) and peer victimization and rejection in kindergarten. For the assessment of children’s difficulties, the authors used a multi-informant approach. METHOD: A total of 153 five-year-old children were interviewed (Berkeley Puppet Interview). Teachers and parents completed the Strengths and Difficulties Questionnaire. Teachers reported on peer victimization. Peer nominations (rejection and acceptance) were conducted in a subgroup of 92 children. Combining teacher, parent, and self-reports of children’s difficulties, three components were established: trait (degree of problems), informant differences resulting from perspective (self versus others), and context (kindergarten versus home). RESULTS: Children’s difficulties were significantly associated with teacher- and self-reported victimization and peer rejection (r = 0.20-0.35), but not with peer acceptance. Conduct problems and emotional symptoms, but not hyperactivity/impulsivity, contributed independently to the variance of peer victimization and rejection. Perspective differences between children and adults according to hyperactivity/impulsivity also predicted peer rejection. CONCLUSION: Behavioral and emotional difficulties as well as a lack of self-awareness regarding hyperactive/impulsive behavior may place children at risk of peer victimization and rejection. Child psychiatric assessments and therapeutic strategies should thus take children’s self-perception of symptoms and their peer relationships into account.
Keywords: behavioral/emotional difficulties; peer rejection; peer victimization; multi-informant approach; kindergarten age
OBJECTIVE: To examine clinicians’ use of Mental Health Outcomes and Assessment Tools (MH-OAT), standardized clinical measures that have been introduced in NSW. METHOD: Two separate studies are described, which examined the use of MH-OAT within two community child and family mental health service teams in Sydney. RESULTS: It appears that clinicians are often not completing the clinician-rated measures and rarely were they requesting and/or following up clients to complete the Strengths and Difficulties Questionnaire. Further, while clinicians are reviewing the progress of their clients, they rarely use the MH-OAT data for this purpose. CONCLUSIONS: Clinicians’ lack of adherence to MH-OAT and use of MH-OAT data are discussed in terms of passive resistance and their possible perception that the process is largely irrelevant to the care of their clients.
Keywords: assessment measures MH-OAT; outcome measurement; psychiatric services.
Background: Attention-deficit/hyperactivity disorder (ADHD) in girls in Europe is poorly understood; it is not known whether they exhibit similar symptom patterns or co-existing problems and receive the same type of treatment as boys. Objective: To examine gender differences for referral patterns, social demographic factors, ADHD core symptomatology, co-existing health problems, psychosocial functioning and treatment. Methods: Baseline data from the ADHD Observational Research in Europe (ADORE) study, a 24-month, naturalistic, longitudinal observational study in 10 European countries of children (aged 6-18 years) with hyperactive/inattentive/impulsive symptoms but no previous diagnosis of ADHD, were analysed by gender. Results: Data from 1,478 children were analysed: 231 girls (15.7%) and 1,222 boys (84.3 %) (gender data missing for 25 patients). Gender ratios (girl:boy) varied by country, ranging from 1:3 to 1:16. Comparisons showed few gender effects in core ADHD symptomatology and clinical correlates of ADHD. Compared with boys, girls had significantly more parent-rated emotional symptoms and prosocial behaviour and were more likely to be the victim of bullying and less likely to be the bully. Girls and boys had similar levels of co-existing psychiatric and physical health problems, and received the same type of treatment. Conclusions: Fewer girls than boys are referred for ADHD treatment, but they have a similar pattern of impairment and receive similar treatment.
Keywords: ADHD; girls; gender differences; Europe
We examined the impact on adolescent socioemotional functioning of maternal postnatal depression (PND) and attachment style. We also investigated the role of earlier aspects of the child’s development-attachment in infancy, and 5-year representations of family relationships. Ninety-one mother-child pairs, recruited in the postnatal period, were followed up at 13 years. Adolescents were interviewed about their friendships, and their level of emotional sensitivity and maturity were rated. Emotional sensitivity was heightened in girls whose mothers experienced PND; notably, its occurrence was also linked to insecure attachment in infancy and raised awareness of emotional components of family relationships at 5 years. High emotional sensitivity was also associated with adolescent depressed mood. Raised social maturity was predicted by a secure maternal attachment style and, for girls, by exposure to maternal PND. Precursors of adolescent social maturity were evident in the narrative coherence of 5-year family representations. Higher social maturity in the friendship interview was also associated with overall good adjustment.
Keywords: [none]
This study examined the treatment sensitivity of the ADHD Questionnaire (ADHD-Q), which is a brief rating scale for measuring symptoms of inattention, hyperactivity, and impulsivity in children. Parent, teacher, and child self-report data of the ADHD-Q were obtained for 17 clinically referred children with ADHD on the three occasions: (1) during the regular intake assessment, (2) just before the start of the stimulant medication (i.e., methylphenidate) intervention, and (3) four weeks after the start of the medication intervention. Results showed that ADHD-Q scores remained fairly stable in the period prior to the intervention, but then showed a substantial decline after the stimulant medication had been administered. Clearly, this finding supports the treatment sensitivity of the ADHD-Q.
Keywords: ADHD; rating scale; treatment sensitivity
OBJECTIVE: To compare prevalence of serious emotional and behavioral problems and mental health contacts for these problems among American and British children and adolescents. METHOD: Data on children and adolescents ages 5 to 16 years were drawn from the 2004 U.S. National Health Interview Survey (response rate = 79.4%) and the 2004 survey of Mental Health of Children and Young People in Great Britain (response rate = 76.0%). Emotional problems, hyperactivity/inattention, and conduct problems were assessed using the parent version of the Strengths and Difficulties Questionnaire (SDQ). Psychometric properties of SDQ scales were compared across countries. RESULTS: The SDQ has similar psychometric properties across countries. More British than American children met the criteria for emotional and conduct problems, but not hyperactivity/inattention. Prevalence was higher for all problems in 5- to 8-year-old British boys and for emotional problems in 13- to 16-year-old British girls. American children with serious emotional and behavioral problems had a higher prevalence of mental health contacts overall and with mental health providers but not with general medical providers. CONCLUSIONS: British children have a higher prevalence of parent-reported serious emotional and behavioral problems than American children. However, British children with these problems are less likely than American children to receive mental health care.
Keywords: epidemiology; mental health services; Strengths and Difficulties Questionnaire
Objective: To assess the prevalence of mental health problems in children in foster care, their families’ use of services and the associated costs. Methods: Information on mental health problems, service use and costs was collected, by postal questionnaires and home interviews, on 182 children, their foster carers and teachers from 17 local authorities in Central Scotland. Results: Over 90% of the children had previously been abused or neglected and 60% had evidence of mental health problems including conduct problems, emotional problems, hyperactivity and problems with peer relations. When compared with 251 children from local schools, the children in foster care had significantly higher symptom scores for Reactive Attachment Disorder. Those children with highest scores for mental health problems were attracting a high level of service support from a wide range of agencies, except Child and Adolescent Mental Health Services (CAMHS). Costs were associated with learning disability, mental health problems, and a history of residential care. Conclusions: Children in ‘mainstream’ foster care are at greater risk of mental health problems, and are attracting greatest costs, but CAMHS are not successfully targeting these problems. CAMHS may need to develop new models of service delivery.
Keywords: foster care; service use; costs
Objective: To examine sex differences in correlates of disruptive behavior disorders (DBDs) in preadolescent children using indicators of a wide range of well-established risk factors for DBDs and outcomes 3 years after initial assessment. Method: Analyses were based on data for 5- to 10-year-olds (n = 5,913) from the British Child and Adolescent Mental Health Survey 1999, and a 3-year follow-up of selected subsamples (n = 1,440) at ages 8 through 13 years. DSM-IV diagnoses were assigned using the Developmental and Well-Being Assessment at both contacts. Results: Boys and girls were equally exposed to most social and family risks for DBDs, with little evidence of differential sensitivity to these risks. Boys were exposed more to neurodevelopmental difficulties, attention-deficit/hyperactivity disorder, and peer problems and had lower rates of prosocial behaviors; together, these factors and physical punishment could account for 54% of the observed sex differences in DBDs. At follow-up, outcomes for girls and boys with DBDs were very similar. For children with subthreshold conduct problems at initial assessment, boys were more likely to go on to exhibit DBDs than were girls (25% versus 7%). Conclusions: Sex differences in the levels of a variety of child characteristics and interpersonal factors are likely to be important in understanding sex differences in risk for DBDs in preadolescent samples.
Keywords: sex differences; preadolescent conduct problems; follow-up; epidemiology
The main aim of this article is to describe the development of a new day treatment program for older children (8-11 years) with behavioural problems. The article outlines the content of the program and it also sets out the rationale behind the development of the new day service. The day program involves therapeutic and educational input and children attend the program two days a week for one academic term (10-13 weeks). Therapeutic input focuses on improving functioning in relation to a number of developmental processes that are known to be linked to the development of problem behaviour. These include improving emotional competence, dealing with peer relationship problems and interpersonal difficulties, and changing negative patterns of thinking about the self and others. The GoZone team also attempt to work collaboratively with the children’s families and schools. A preliminary investigation of the effectiveness of the program is also reported. Parents and teachers completed the Strengths and Difficulties Questionnaire (SDQ) pre- and posttreatment. Findings showed that over the course of treatment parents reported a significant decrease in overall levels of emotional and behavioural problems and also reported a significant decrease in levels of emotional symptoms and peer problems. However, no significant changes in emotional and behavioural functioning were reported by teachers at school over the course of treatment. Potential ways of boosting the magnitude of positive change achieved by the new day treatment program are discussed.
Keywords: behavioural problems; day treatment services
